Researchers examine link between housing and health

Housing and its connection to health in the United States are beginning to be explored on new levels, and Greensboro is playing a part in that research. Earlier this year, Greensboro joined 50 other cities involved with Invest Health.

Invest Health is an initiative whose self-described goal is to “develop new strategies for increasing and leveraging private and public investments to accelerate improvements in neighborhoods facing the biggest barriers to better health.”

The program is a collaboration between the Robert Wood Johnson Foundation and Reinvestment Fund.

A unique partnership in Greensboro formed around the project, including the Cone Health Foundation, the City of Greensboro, East Street Market Development Corp., the Greensboro Housing Coalition, UNCG and the Triad Healthcare Network. The purpose of the group was to research and contribute to the knowledge base of housing and health on multiple levels.

Out of some 180 applications, 50 cities were selected for Invest Health. In North Carolina, Greensboro, Durham and Asheville made it onto the participating teams. Greensboro had the edge of strong housing groups and advocates, and the city already working closely with the university researchers and local health system.

Local researchers will focus on the effect of substandard housing on incidence of asthma. Research by the NC Department of Health Services found that nearly a third of children in North Carolina visited the ER or Urgent Care due to asthma last year. The Asthma and Allergy Foundation of America also found that Greensboro’s asthma rate is influenced by higher than average poverty and uninsured rates.
Director of the Center for Housing and Community Studies, Dr. Stephen Sills, has been involved with Greensboro’s Invest Health along with the Director of Community Outreach for Cone Health, Kathy Colville.

“We can really think of it in terms of the emergency department is probably one of the most expensive places for us to pay for housing, which is an interesting way to think about it,” said Colville. “We don’t often think about the fact that we might actually be paying for the consequences for unhealthy or unsafe housing in the emergency department.

“We don’t want people’s health to get to the point where they have to be in the emergency department. That makes recovery more difficult. It means you’re probably missing school or work. If there is the ability to make a relatively inexpensive housing assessment or a repair to a home that can save those costs downstream, then it’s saved cost but it’s also saved the patient experience of having to become that sick, of having to recover from that.”

Research has found many environmental factors can trigger asthma attacks, especially in unmaintained, low-income housing. Unmaintained roofs can lead to roof leaks, leading to water content in the wood, and producing mold. Many older houses are without proper ventilation and can be made of materials that contain lead.

Vacant homes can create pests that move from house to house spreading fur, dander and feces, which typically lead to the use of pesticides and other chemicals. All these are factors that can exacerbate asthma issues.

“The principle goal is an asthma friendly city,” said Dr. Sills. “There’s no way to completely eradicate asthma, it’s genetically linked and environmentally triggered. We can reduce the environmental triggers by substandard housing through strategic code enforcement, through a pigment of mold and other allergens in the home.

“Simple fixes like roof leaks, ceiling fans and bathrooms, stopping the use of certain types of pesticides and insecticides in the home and raising awareness within the community. Getting rid of vacant and abandoned houses. Rehabilitating some and turning them back into reusable houses for the community. These strategies together can reduce the environmental triggers of asthma and make it more of an asthma friendly city.”

Dr. Sills is already seeing progress since Invest Health began working with Greensboro.

“It’s really begun to focus our energy around this issue of substandard housing, provided us with some tools on how to attract investors, we’ve gone through a series of webinars to learn about community health indicators, we have access to some online resources…,” he said.

“We have a team of experts at the national level who are advising us in how to tailor our project better towards the investment community. We’re engaging the stakeholders within the community around the issue of pediatric asthma, attracted pediatricians, nurses in school systems, officials with the school system, other divisions of the city who are already working on the project, and a lot of backing from the health community.”

Community housing advocate, Beth McKee-Huger, is also on the Greensboro Invest Health team with Dr. Sills and Colville.

“It’s really wonderful to see community partners recognizing that investment in housing conditions makes a difference in health,” she said. “We don’t really have good policies and programs for how to get investment in repairing dilapidated housing in order to impact health. So Invest Health gives Greensboro the opportunity to figure out.”

So far, the Invest Health team is still in the early research phase. The initiative will take about 18 months and lead to future funding by Reinvestment Fund for other major initiatives.